MED SURG EXAM 3 STUDY GUIDE
QUESTIONS AND CORRECT ANSWERS
AfterA2aA2patientA2hasA2undergoneA2aA2rhinoplasty,A2whichA2nursingA2interventionA2willA2b
eA2includedA2inA2theplanA2ofA2care?
a.A2EducateA2theA2patientA2aboutA2howA2toA2safelyA2removeA2andA2reapplyA2nasalA2packin
g.
b.A2ReassureA2theA2patientA2thatA2theA2noseA2willA2lookA2normalA2whenA2theA2swellingA2su
bsides.
c.A2InstructA2theA2patientA2toA2keepA2theA2headA2elevatedA2forA248A2hoursA2toA2minimizeA2s
wellingA2andA2pain.
d.A2TeachA2theA2patientA2toA2useA2nonsteroidalA2anti-
inflammatoryA2drugsA2(NSAIDs)A2forA2painA2control.A2-A2Ans--ANS:A2C
RationaleA2:A2MaintainingA2theA2headA2inA2anA2elevatedA2positionA2willA2decreaseA2theA2a
mountA2ofA2nasalA2swelling.A2NSAIDsA2increaseA2theA2riskA2forA2postoperativeA2bleedingA2
andA2shouldA2notA2beA2usedA2postoperatively.A2TheA2patientA2wouldA2notA2beA2taughtA2toA
2removeA2orA2reapplyA2nasalA2packing,A2whichA2isA2usuallyA2removedA2byA2thesurgeonA2o
nA2theA2dayA2afterA2surgery.A2AlthoughA2returnA2toA2aA2preinjuryA2appearanceA2isA2theA2go
alA2ofA2thesurgery,A2itA2isA2notA2alwaysA2possibleA2toA2achieveA2thisA2result.
AfterA2discussingA2managementA2ofA2upperA2respiratoryA2infectionsA2(URI)A2withA2aA2patie
ntA2whoA2hasA2acuteviralA2rhinitis,A2theA2nurseA2determinesA2thatA2additionalA2teachingA2is
A2neededA2whenA2theA2patientA2says
a.A2IA2canA2takeA2acetaminophenA2(Tylenol)A2toA2treatA2discomfort.‖
b.A2IA2willA2drinkA2lotsA2ofA2juicesA2andA2otherA2fluidsA2toA2stayA2hydrated.‖
c.A2IA2canA2useA2myA2nasalA2decongestantA2sprayA2untilA2theA2congestionA2isA2allA2gone.‖
d.A2IA2willA2watchA2forA2changesA2inA2nasalA2secretionsA2orA2theA2sputumA2thatA2IA2coughA2
up.‖A2-A2Ans--ANS:A2C
Rationale:A2TheA2nurseA2shouldA2clarifyA2thatA2nasalA2decongestantA2spraysA2shouldA2beA
2usedA2forA2noA2moreA2thanA23A2daysA2toA2preventA2reboundA2vasodilationA2andA2congesti
on.A2TheA2otherA2responsesA2indicateA2thatA2theA2teachingA2hasA2beenA2effective.
TheA2nurseA2isA2obtainingA2aA2healthA2historyA2fromA2aA267-year-
oldA2patientA2withA2aA240A2pack-
yearA2smokingA2history,A2complaintsA2ofA2hoarsenessA2andA2tightnessA2inA2theA2throat,A2a
ndA2difficultyA2swallowing.A2WhichA2questionA2isA2mostA2importantA2forA2theA2nurseA2toA2as
k?
a.A2HowA2muchA2alcoholA2doA2youA2drinkA2inA2anA2averageA2week?‖
b.A2DoA2youA2haveA2aA2familyA2historyA2ofA2headA2orA2neckA2cancer?‖
c.A2HaveA2youA2hadA2frequentA2streptococcalA2throatA2infections?‖
d.A2DoA2youA2useA2antihistaminesA2forA2upperA2airwayA2congestion?‖A2-A2Ans--ANS:A2A
Rationale:A2ProlongedA2alcoholA2useA2andA2smokingA2areA2associatedA2withA2theA2develo
pmentA2ofA2laryngealA2cancer,
, whichA2theA2patient'sA2symptomsA2andA2historyA2suggest.A2FamilyA2historyA2isA2notA2aA2ris
kA2factorA2forA2headA2orA2neckA2cancer.A2FrequentA2antihistamineA2useA2wouldA2beA2aske
dA2aboutA2ifA2theA2nurseA2suspectedA2allergicA2rhinitis,A2butA2theA2patient'sA2symptomsA2ar
eA2notA2suggestiveA2ofA2thisA2diagnosis.A2StreptococcalA2throatA2infectionsA2alsoA2mayA2c
auseA2theseA2clinicalA2manifestations,A2butA2patientsA2alsoA2willA2complainA2ofA2painA2and
A2fever.
WhichA2ofA2theseA2patientsA2inA2theA2respiratoryA2diseaseA2clinicA2shouldA2theA2nurseA2as
sessA2first?
a.A2AA223-year-old,A2complainingA2ofA2aA2soreA2throat,A2whoA2hasA2aA2hotA2potatoA2voice
b.A2AA234-year-
oldA2whoA2hasA2aA2scratchyA2throat‖A2andA2aA2positiveA2rapidA2strepA2antigenA2test
c.A2AA255-year-
oldA2whoA2isA2receivingA2radiationA2forA2throatA2cancerA2andA2hasA2severeA2fatigue
d.A2AA272-year-
oldA2withA2aA2historyA2ofA2aA2totalA2laryngectomyA2whoseA2stomaA2isA2redA2andA2inflamedA
2-A2Ans--ANS:A2A
Rationale:A2TheA2patient'sA2clinicalA2manifestationA2ofA2aA2hotA2potatoA2voiceA2suggestsA2
aA2possibleA2peritonsillarA2abscessA2thatA2couldA2leadA2toA2anA2airwayA2obstructionA2requi
ringA2rapidA2assessmentA2andA2potentialA2treatment.A2TheA2otherA2patientsA2doA2notA2hav
eA2diagnosesA2orA2symptomsA2thatA2indicateA2anyA2life-threateningA2problems
TheA2nurseA2obtainsA2theA2followingA2assessmentA2dataA2inA2aA276-year-
oldA2patientA2whoA2hasA2influenza.A2WhichA2informationA2willA2beA2mostA2importantA2toA2c
ommunicateA2toA2theA2healthA2careA2provider?
a.A2FeverA2ofA2100.4°A2FA2(38°A2C)
b.A2DiffuseA2cracklesA2inA2theA2lungs
c.A2SoreA2throatA2andA2frequentA2cough
d.A2MyalgiaA2andA2persistentA2headacheA2-A2Ans--ANS:A2B
Rationale:A2TheA2cracklesA2indicateA2thatA2theA2patientA2mayA2beA2developingA2pneumoni
a,A2aA2commonA2complicationA2ofA2influenza,A2whichA2wouldA2requireA2aggressiveA2treatm
ent.A2Myalgia,A2headache,A2mildA2temperatureA2elevation,A2andA2soreA2throatA2withA2coug
hA2areA2typicalA2symptomsA2ofA2influenzaA2andA2areA2treatedA2withA2supportiveA2careA2me
asuresA2suchA2asA2over-the-
counterA2(OTC)A2painA2relieversA2andA2increasedA2fluidA2intake
WhichA2ofA2theseA2nursingA2actionsA2canA2theA2RNA2workingA2inA2aA2long-
termA2careA2facilityA2delegateA2toA2anA2experiencedA2LPNA2orA2LVNA2whoA2isA2caringA2forA
2aA2patientA2withA2aA2permanentA2tracheostomy?
a.A2AssessingA2theA2patient'sA2riskA2forA2aspiration
b.A2SuctioningA2theA2tracheostomyA2whenA2needed
c.A2EducatingA2theA2patientA2aboutA2self-careA2ofA2theA2tracheostomy
d.A2DeterminingA2theA2needA2forA2replacementA2ofA2theA2tracheostomyA2tubeA2-A2Ans--
ANS:A2B
Rationale:A2SuctioningA2ofA2aA2stableA2patientA2canA2beA2delegatedA2toA2LPNA2orA2LVNs.A
2AssessmentsA2andA2patientA2teachingA2shouldA2beA2doneA2byA2theA2RN
QUESTIONS AND CORRECT ANSWERS
AfterA2aA2patientA2hasA2undergoneA2aA2rhinoplasty,A2whichA2nursingA2interventionA2willA2b
eA2includedA2inA2theplanA2ofA2care?
a.A2EducateA2theA2patientA2aboutA2howA2toA2safelyA2removeA2andA2reapplyA2nasalA2packin
g.
b.A2ReassureA2theA2patientA2thatA2theA2noseA2willA2lookA2normalA2whenA2theA2swellingA2su
bsides.
c.A2InstructA2theA2patientA2toA2keepA2theA2headA2elevatedA2forA248A2hoursA2toA2minimizeA2s
wellingA2andA2pain.
d.A2TeachA2theA2patientA2toA2useA2nonsteroidalA2anti-
inflammatoryA2drugsA2(NSAIDs)A2forA2painA2control.A2-A2Ans--ANS:A2C
RationaleA2:A2MaintainingA2theA2headA2inA2anA2elevatedA2positionA2willA2decreaseA2theA2a
mountA2ofA2nasalA2swelling.A2NSAIDsA2increaseA2theA2riskA2forA2postoperativeA2bleedingA2
andA2shouldA2notA2beA2usedA2postoperatively.A2TheA2patientA2wouldA2notA2beA2taughtA2toA
2removeA2orA2reapplyA2nasalA2packing,A2whichA2isA2usuallyA2removedA2byA2thesurgeonA2o
nA2theA2dayA2afterA2surgery.A2AlthoughA2returnA2toA2aA2preinjuryA2appearanceA2isA2theA2go
alA2ofA2thesurgery,A2itA2isA2notA2alwaysA2possibleA2toA2achieveA2thisA2result.
AfterA2discussingA2managementA2ofA2upperA2respiratoryA2infectionsA2(URI)A2withA2aA2patie
ntA2whoA2hasA2acuteviralA2rhinitis,A2theA2nurseA2determinesA2thatA2additionalA2teachingA2is
A2neededA2whenA2theA2patientA2says
a.A2IA2canA2takeA2acetaminophenA2(Tylenol)A2toA2treatA2discomfort.‖
b.A2IA2willA2drinkA2lotsA2ofA2juicesA2andA2otherA2fluidsA2toA2stayA2hydrated.‖
c.A2IA2canA2useA2myA2nasalA2decongestantA2sprayA2untilA2theA2congestionA2isA2allA2gone.‖
d.A2IA2willA2watchA2forA2changesA2inA2nasalA2secretionsA2orA2theA2sputumA2thatA2IA2coughA2
up.‖A2-A2Ans--ANS:A2C
Rationale:A2TheA2nurseA2shouldA2clarifyA2thatA2nasalA2decongestantA2spraysA2shouldA2beA
2usedA2forA2noA2moreA2thanA23A2daysA2toA2preventA2reboundA2vasodilationA2andA2congesti
on.A2TheA2otherA2responsesA2indicateA2thatA2theA2teachingA2hasA2beenA2effective.
TheA2nurseA2isA2obtainingA2aA2healthA2historyA2fromA2aA267-year-
oldA2patientA2withA2aA240A2pack-
yearA2smokingA2history,A2complaintsA2ofA2hoarsenessA2andA2tightnessA2inA2theA2throat,A2a
ndA2difficultyA2swallowing.A2WhichA2questionA2isA2mostA2importantA2forA2theA2nurseA2toA2as
k?
a.A2HowA2muchA2alcoholA2doA2youA2drinkA2inA2anA2averageA2week?‖
b.A2DoA2youA2haveA2aA2familyA2historyA2ofA2headA2orA2neckA2cancer?‖
c.A2HaveA2youA2hadA2frequentA2streptococcalA2throatA2infections?‖
d.A2DoA2youA2useA2antihistaminesA2forA2upperA2airwayA2congestion?‖A2-A2Ans--ANS:A2A
Rationale:A2ProlongedA2alcoholA2useA2andA2smokingA2areA2associatedA2withA2theA2develo
pmentA2ofA2laryngealA2cancer,
, whichA2theA2patient'sA2symptomsA2andA2historyA2suggest.A2FamilyA2historyA2isA2notA2aA2ris
kA2factorA2forA2headA2orA2neckA2cancer.A2FrequentA2antihistamineA2useA2wouldA2beA2aske
dA2aboutA2ifA2theA2nurseA2suspectedA2allergicA2rhinitis,A2butA2theA2patient'sA2symptomsA2ar
eA2notA2suggestiveA2ofA2thisA2diagnosis.A2StreptococcalA2throatA2infectionsA2alsoA2mayA2c
auseA2theseA2clinicalA2manifestations,A2butA2patientsA2alsoA2willA2complainA2ofA2painA2and
A2fever.
WhichA2ofA2theseA2patientsA2inA2theA2respiratoryA2diseaseA2clinicA2shouldA2theA2nurseA2as
sessA2first?
a.A2AA223-year-old,A2complainingA2ofA2aA2soreA2throat,A2whoA2hasA2aA2hotA2potatoA2voice
b.A2AA234-year-
oldA2whoA2hasA2aA2scratchyA2throat‖A2andA2aA2positiveA2rapidA2strepA2antigenA2test
c.A2AA255-year-
oldA2whoA2isA2receivingA2radiationA2forA2throatA2cancerA2andA2hasA2severeA2fatigue
d.A2AA272-year-
oldA2withA2aA2historyA2ofA2aA2totalA2laryngectomyA2whoseA2stomaA2isA2redA2andA2inflamedA
2-A2Ans--ANS:A2A
Rationale:A2TheA2patient'sA2clinicalA2manifestationA2ofA2aA2hotA2potatoA2voiceA2suggestsA2
aA2possibleA2peritonsillarA2abscessA2thatA2couldA2leadA2toA2anA2airwayA2obstructionA2requi
ringA2rapidA2assessmentA2andA2potentialA2treatment.A2TheA2otherA2patientsA2doA2notA2hav
eA2diagnosesA2orA2symptomsA2thatA2indicateA2anyA2life-threateningA2problems
TheA2nurseA2obtainsA2theA2followingA2assessmentA2dataA2inA2aA276-year-
oldA2patientA2whoA2hasA2influenza.A2WhichA2informationA2willA2beA2mostA2importantA2toA2c
ommunicateA2toA2theA2healthA2careA2provider?
a.A2FeverA2ofA2100.4°A2FA2(38°A2C)
b.A2DiffuseA2cracklesA2inA2theA2lungs
c.A2SoreA2throatA2andA2frequentA2cough
d.A2MyalgiaA2andA2persistentA2headacheA2-A2Ans--ANS:A2B
Rationale:A2TheA2cracklesA2indicateA2thatA2theA2patientA2mayA2beA2developingA2pneumoni
a,A2aA2commonA2complicationA2ofA2influenza,A2whichA2wouldA2requireA2aggressiveA2treatm
ent.A2Myalgia,A2headache,A2mildA2temperatureA2elevation,A2andA2soreA2throatA2withA2coug
hA2areA2typicalA2symptomsA2ofA2influenzaA2andA2areA2treatedA2withA2supportiveA2careA2me
asuresA2suchA2asA2over-the-
counterA2(OTC)A2painA2relieversA2andA2increasedA2fluidA2intake
WhichA2ofA2theseA2nursingA2actionsA2canA2theA2RNA2workingA2inA2aA2long-
termA2careA2facilityA2delegateA2toA2anA2experiencedA2LPNA2orA2LVNA2whoA2isA2caringA2forA
2aA2patientA2withA2aA2permanentA2tracheostomy?
a.A2AssessingA2theA2patient'sA2riskA2forA2aspiration
b.A2SuctioningA2theA2tracheostomyA2whenA2needed
c.A2EducatingA2theA2patientA2aboutA2self-careA2ofA2theA2tracheostomy
d.A2DeterminingA2theA2needA2forA2replacementA2ofA2theA2tracheostomyA2tubeA2-A2Ans--
ANS:A2B
Rationale:A2SuctioningA2ofA2aA2stableA2patientA2canA2beA2delegatedA2toA2LPNA2orA2LVNs.A
2AssessmentsA2andA2patientA2teachingA2shouldA2beA2doneA2byA2theA2RN